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Breast Feeding by Dr Alison Soerensen

Breast Feeding

Posted on 31st October, 2017 at 9:00 AM


***Midnight. Sitting in the dark. Baby fussing. “Why won’t you sleep? Are you hungry? Do I have enough milk? Is there something wrong with it?”***

Sound familiar? It is a common experience for breastfeeding mums to question their supply yet the vast majority do produce enough milk for their baby. So why might a woman think she has low supply?

  • Soft breasts: in the early days when your breastmilk “comes in” it is common for your breasts to feel full and engorged before a feed. As time goes on, your supply adjusts to meet your baby’s needs. You may then only experience engorgement occasionally – like when you baby takes a longer than normal sleep.
  • Short feeds: As babies get bigger, they often become more efficient at removing milk
  • Sudden increase in the number of feeds:babies go through growth spurts and will feed frequently to increase your supply. It usually settles after a couple of days.
  • Frequent feeds: Breastfed babies, particularly in the early days, will commonly feed 10-12+ times a day (i.e. every 2hrs).
  • Evening/afternoon cluster feeding – breasts naturally make milk that is higher in fat but smaller in volume as the day goes on. Babies are thought to cluster feed in the evenings to stock up on this rich milk which takes longer to digest and promotes consolidated periods of sleep.

So how can you know if your baby is getting enough?

  • From 5 days of age, at least 5 very wet disposable nappies a day (or 6-8 cloth nappies)
  • Frequent runny stools are common in the early days, usually 3+ a day and sometimes one with every feed. This usually becomes less frequent as babies get older, sometimes only passing stool once every 10-14 days!
  • Appropriate weight gain: the amount will vary between babies as like adults, they come in all shapes and sizes. If concerned, discuss your baby’s growth with your GP or child health nurse.
  • Baby is generally content between feeds, although periods of cluster feeding and unsettledness are normal too.

What should I do if I think I have low supply?

  • When it comes to breastfeeding, demand = supply. What this means is the more milk removed from the breasts (either by baby or by expressing), the more milk your breasts will make. You can achieve this by offering extra breastfeeds during the day or pumping between feeds. ‘Skin to skin’ time with baby can also be helpful to boost supply.
  • See a health professional experienced in lactation to make sure baby is correctly attached and positioned. Poor latch can result in inefficient milk transfer which can lead to reduced supply.
  • See your GP or other health professional to monitor baby’s growth

A final note on galactagogues:

  • Galactagogues are medications/supplements that increase milk supply
  • The most common medication used in Australia is domperidone 10-20mg, three times a day.
  • There are many herbs that have been used around the world to enhance lactation. They contain pharmacologically active ingredients but in most cases, there is minimal evidence about both the effective dose required to improve supply and the safety of these substances.
  • Galactagogues are rarely the answer on their own and should only be taken after supply issues are confirmed and after other modifiable issues are resolved (i.e. infrequent feeding, poor latch, maternal health issues etc).

If you’d like to know more, feel free come along to one of my breastfeeding information sessions, make an appointment with me or check out the Australian Breastfeeding Association’s website